MEDICAL, DENTAL, VISION, HEARING, OR BEHAVIORAL …

Use this form to document medical, dental, vision, hearing and behavioral health (Child and Adolescent Needs and Strengths assessment (CANS)) appointments. CK NOTE TO FAMILY: ALL 5 PAGES AND BOLDED ITEMS ARE REQUIRED FIELDS. Completion of this form meets requirements in: ... Routine Texas Health Steps Medical Checkup. (Required at the following ... ................
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